Unusually Giant Sublingual Epidermoid Cyst: A Case Report

Document Type : Case Report

Authors

Department of Otorhinolaryngology, Dr. Shankarrao Chavan Govt. Medical College, Nanded, India.

Abstract

Introduction:
Epidermoid cysts are rare, slow‑growing, benign, developmental cysts, which are derived from abnormally situated ectodermal tissue. Epidermoid cysts of the floor of the mouth represent <0.01% of all oral cysts. So far, only a few cases have been reported.
Case Report:
Hereby, we present a case of a giant sublingual epidermoid cyst, which was completely asymptomatic upon presentation. However, due to its large size, it pushed the epiglottis posteriorly and created difficulty during intubation. The patient developed respiratory distress after its surgical excision and extubation, requiring tracheostomy post operatively. The patient recovered well and a successful weaning of tracheostomy was performed, giving the patient a healthy life.
Conclusion:
Epidermoid cyst is a rare differential diagnosis of sublingual swelling that should be kept in mind for large asymptomatic swellings in this region. The only symptom it can cause might be respiratory distress due to its large size. This can happen not only pre-operatively but also post-operatively and the surgeon should be ready for immediate tracheostomy.

Keywords

Main Subjects


1. Shafer WG, Hine MK, Levy BM. A Text Book of Oral Pathology. 4th ed. Philadelphia: WB Saunders; 1993. p. 67.
2. Calderon S, Kaplan I. Concomitant sublingual and submental epidermoid cysts: a case report. J Oral Maxillofac Surg. 1993; 51:790–2.
3. Cortezzi W, De Albuquerque EB. Secondarily infected epidermoid cyst in the floor of the mouth causing a life threatening situation. J Oral Maxillofac Surg. 1994; 52:762–4.
4. Worley CM, Laskin DM. Coincidental sublingual and submental epidermoid cyst. J Oral Maxillofac Surg. 1993;51: 787–90.
5. De Ponte FS, Brunelli A, Marchetti E, Bottini DJ. Sublingual epidermoid cyst. J Craniofac Surg. 2002; 13(2):308–10.
6. Gold BD, Sheinkonf DE, Levy B. Dermoid, Epidermoid and teratoid cysts of the tongue and the floor of the mouth. J Oral Surg. 1974; 32:107.
7. Yoshinari M, Nagayama M. Epidermoid cyst of the uvula. J Oral Maxillofac Surg. 1986; 44:828–9.
8. Zachariades N, Skoura-Kafoussia C. A life threatening epidermoid cyst of the floor of the mouth: report of a case. J Oral Maxillofac Surg. 1990; 48: 400–3.
9. Howell CJT. The sublingual dermoid cyst. Oral Surg Oral Med Oral Pathol. 1985; 59:578–80.
10. Coit WE, Harnsberger HR, Osborn AG, Smoker WR, Stevens MH, Lufkin RB. Ranulas and their mimics: CT evaluation. Radiology 1987; 163:211-6.
11. Longo F, Maremonti P, Mangone GM, De Maria G, Califano L. Midline (dermoid) cysts of the floor of the mouth: report of 16 cases and review of surgical techniques. Plast Reconstr Surg 2003; 112(6): 1560–5.
12. Damle MV, Irani DK, Hiranandani NL. Epidermoid cyst of the floor of the mouth. Case report. Bombay Hosp J 2002;44:267‑70.
13. Hemaraju N, Nanda SK, Medikeri SB. Sub‑lingual dermoid cyst. Indian J Otolaryngol Head Neck Surg 2004;56:218‑20.
14. Shear M. Cyst of the oral regions. 3rd ed. Wright, Oxford; 1992: 196–208.
15. Walstad William R, Solomon James M, Schow Sterling R, Ochs Mark W. Midline cystic lesion of the floor of the mouth. J Oral Maxillofacial Surg 1998;  56:70–4.
16. Jham BC, Duraes GV, Jham AC, Santos CR. Epidermoid cyst of the floor of the mouth: a case report. J Can Dent Assoc. 2007 Jul-Aug;73(6):525-8.
17. Ikeda I, Ono T. Basal cell carcinoma originating from an epidermoid cyst. J Dermatol 1990; 17:643–6.
18. Lopez RF, Rodriguez Peralto JL, Castano E, Benito A. Squamous cell carcinoma arising in a cutaneous epidermal cyst: Case report and literature review. Am J Dermatol Pathol 1999; 21:174–7.